4. Policies and Procedures for Dealing with HIV/Aids in the Workplace

The UN Global Compact Policy Dialogues

The Global Compact was launched in July 2000 to encourage collaboration between the UN system and the private sector in addressing the challenges of globalization and promoting the application of nine core principles.

It convenes thematic multistakeholder Policy Dialogues to give practical meaning to these principles by creating an international platform for mutual understanding and problem-solving among business, labour, civil society organizations, government, UN agencies and leading commentators.

The Dialogue process is designed to assist in the identification of new and emerging issues, promote multistakeholder trust and interaction, and support advocacy with policymakers.

The Global Compact Policy Dialogue on HIV/AIDS convened on 12-13 May at the ILO in Geneva with the support of UNAIDS aimed to identify policy issues that could benefit from the problem-solving approach of the Global Compact. The meeting explored key challenges companies face and examples of effective responses to HIV/AIDS in the workplace.

The ILO and HIV/AIDS in the world of work

The ILO is the UN agency with primary responsibility for the world of work.

The HIV epidemic mainly affects adults of working age - the active population of a nation. It has now spread to the extent that socio-economic security and development are being undermined by the incapacity and loss of government officials, business people, trade union activists and community leaders.

In June 2000, following a Resolution on HIV/AIDS passed at the International Labour Conference, ILO Director-General Juan Somavia requested all Programmes and units - at headquarters and in the field – to mainstream the issue in their work. In November 2000 the ILO Programme on HIV/AIDS and the World of Work (ILO/AIDS) were formally established.

Since that time the ILO has developed a Code of Practice on HIV/AIDS and the world of work, has worked to mobilize its tripartite constituents and strengthen their capacity to respond to the epidemic, and has provided advisory services and technical assistance at the country level.

The business and labour response

Employers and workers have a vital role to play in the fight against HIV/AIDS, starting in their own workplaces but also offering leadership in the wider community. The recognition that HIV/AIDS is an issue of enlightened self-interest, as well as corporate responsibility, is driving companies to engage. There are examples across the world of businesses working together to establish effective workplace programmes and policies, often in close collaboration with government and workers' organizations.

The challenge is to find and replicate efficient and cost-effective interventions that limit the spread of infection and mitigate its impact.

Examples of action increase daily, ranging from the provision of antiretroviral treatment by multinational companies such as DaimlerChrysler and de Beers to the training of thousands of peer educators by companies as diverse as Tata Tea in South India and the Zambia Revenue Authority.

Decisions about the provision of care, including antiretroviral treatment, are made in the context of growing concern about the human and socioeconomic consequences of the epidemic on the one hand and on the other new opportunities created by the lowering of drug prices and increased resource availability. Concerted efforts are being made to increase funding through mechanisms such as the World Bank's Multi-country AIDS Programs (MAP) and the Global Fund to Fight AIDS, TB and Malaria.

The imperative for the world of work is to contribute to national and international efforts that both prevent the spread of HIV and also manage and mitigate its impact.

A policy framework

The ILO Code of Practice on HIV/AIDS and the world of work provides a framework agreed upon through tripartite and inter-regional consultations for programme and policy development.

It helps the workplace partners implement:

• Policies that oppose discrimination and promote an environment of open and constructive discussion of HIV issues.
• Programmes based on participatory and gender-sensitive education methods that enable individuals to assess their risk and make changes to their behaviour that include practical measures to support behaviour change, from VCT and STI treatment to condom availability that offer care and support to those affected by the epidemic, from reasonable accommodation and advice on healthy living to the treatment of the virus and/or associated infections (e.g. tuberculosis).
• Guidelines for employers on practical measures to minimize disruption to production, from the use of teams and restructuring of training to new models of medical insurance.
• Decision-making to ensure effective implementation and monitoring and support structures.
• Public-private that brings support from the private sector and labour partnerships organizations for government and UN efforts, especially in increasing access to treatment.

In welcoming delegates to the Policy Dialogue, Georg Kell, Executive Head of the Global Compact, and Juan Somavia, Director-General of the ILO, stressed the importance and value of sustained dialogue, close collaboration and, above all, concrete action in fighting HIV/AIDS in the world of work.

The key objectives of the IOE's response are to protect those who have not been infected, to manage HIV/AIDS in the workplace and to support community initiatives.

The IOE is involving and supporting employers in the region through:

• Mobilization seminars.
• Developing workplace policies and time-bound action plans.
• Encouraging collaboration with trade unions and other partners.
• Advice for companies on prevention programmes, including peer education and the promotion of behaviour change.
• 'Domesticating' the ILO Code of Practice and tailoring it to local needs.
• Working with companies on the provision of care, support and treatment.
• Disseminating examples of successful workplace action.
• Helping companies remove stigma and discrimination and create a supportive workplace environment.

As part of a multisectoral response to HIV/AIDS, the IOE collaborates with National AIDS Coordinating Committees (NACC), works with unions and organizations of PLWHA, and supports business coalitions on HIV/AIDS. It uses the ILO Code of Practice to guide actions and develop workplace policies and has produced a handbook for employers on HIV/AIDS. The IOE recently took part in an ICFTU workshop on workplace strategies and programmes in Nairobi.

All companies are encouraged to make a contribution - even small and medium-sized enterprises (SMEs) that may lack resources and expertise.

Frederick Muia stressed the importance of involving all stakeholders in committing to participation in workplace programmes including care and support, to help ensure that initiatives are financially sustainable over a long period.

The HIV pandemic has become one of the most critical workplace issues of our time. In addition to its devastating impact on working women and men and their families and dependents, HIV affects the world of work in many ways. Stigma and discrimination against people living with and affected by HIV and AIDS threaten fundamental rights at work, undermining opportunities for people to obtain decent work and sustainable employment.

By adopting the Recommendation concerning HIV and AIDS and the World of Work (No. 200) in 2010, the ILO’s member States reaffirmed their commitment to prevent HIV and address discrimination in the workplace. Recommendation No. 200 builds on the ILO Code of practice on HIV/AIDS. It is the first international labour standard for protecting human rights at work for persons living with and affected by HIV and AIDS. The Recommendation calls for the development and adoption of national tripartite HIV workplace policies and programmes through an inclusive dialogue process involving governments, organizations of employers and workers, and organizations representing persons living with HIV and taking into account the views of relevant sectors, including the health sector.

Legislation and policies

This collection contains national legislation and policies adopted by ILO member States relevant to the issue of HIV/AIDS and the world of work. The entry for each Member State provides a section on legislation, which encompasses a wide range of legislative texts, such as constitutional law, public health, discrimination/equality, labour, occupational safety and health, etc. There is also a section for each member State containing national policies and strategies, as well as a range of documents adopted by governments, employers’ organizations, workers’ organizations, business coalitions, as well as relevant policy and strategy documents drafted by civil society associations and networks, such as networks of persons living with HIV (PLHIV).

ILO constituents and HIV/AIDS

Ministries of Labour, employers, workers and their organizations have a vital role to play in the HIV/AIDS response.

With its overall responsibility for the national workforce and labour legislation, the Ministry of Labour is a key partner in the national HIV/AIDS response. Employers’ and workers’ organizations can also be a major force in civil society. They can play a significant leadership role at the national level by mobilizing their constituencies and extensive networks.

The ILO Recommendation concerning HIV and AIDS and the World of Work, 2010 and the ILO code of practice on HIV/AIDS and the world of work define a broad range of rights and responsibilities for each of the constituents of the ILO to guide their complementary or joint actions.

Tripartite structures are in place in many countries; they have often taken HIV/AIDS onto their agendas. The three partners have come together to develop laws, national workplace policies or commitments on HIV/AIDS.

1. Governments: Ministries of Labour
2. Employers and their organizations
3. Workers and their organizations

“Mainstreaming HIV/AIDS is a key priority in the Ministry of Labour” 

Mr Trevor Thomas, Permanent Secretary, Ministry of Labour, Human Services and Social Security, Guyana.

“With the help of the International Labour Organization and the National AIDS Control Organization, it is the first time that we are developing a national policy on HIV/AIDS and the world of work.”

Mr S. K. Srivastava, Additional Secretary, Ministry of Labour and Employment, India.

“When I was first appointed as Director of Health and Safety and counterpart to the project, very little was happening regarding HIV/AIDS. The capacity of the Ministry, especially labour inspectors, was very minimal. However, the ILO project has managed to train our inspectors and I am proud that we have now incorporated HIV/AIDS into the labour inspectors’ checklist.’’

Ms Ntseketsi Mohale, Director of Occupational Health and Safety, Ministry of Labour and Employment, Lesotho.

Building a multisectoral response: Working with ministries of Labour

Governments are at the frontline of the HIV/AIDS response. Strong political commitment is essential to the success of any HIV programme. With their overall responsibility for the national workforce and labour legislation, ministries of Labour can play a key role in national HIV/AIDS responses.

The integration of HIV/AIDS responses into the administration, structures and programmes of ministries of Labour brings the double advantage that HIV/AIDS interventions are informed and supported by experienced officials as well as rooted in structures that can be sustained over the longer term. Their actions include:

• Taking the lead in developing national HIV/AIDS workplace legislation and policies in collaboration with employers’ and workers’ organizations and national AIDS programmes
• Integrating HIV/AIDS into training programmes of the ministry and its institutions to reach employers, unions, labour inspectors, labour judges, occupational safety and health officials, etc.
• Incorporating HIV/AIDS training within workers’ education, vocational training/apprenticeship, skills development and migrant workers programmes.
• Ensuring that government programmes promoting gender equality, women’s entrepreneurship, youth employment, and the elimination of child labour take HIV/AIDS into account and address related issues.
• Making sure that the social protection systems in place address vulnerabilities which could put workers more at risk of becoming infected and do not discriminate against people living with HIV and their family members.
• Integrating HIV/AIDS training into small-enterprise development and cooperative-development programmes while ensuring that micro-finance schemes do not discriminate against people living with HIV/AIDS.

The government is the largest employer in many countries. HIV/AIDS creates extra demand for many public services, especially health and social services. Not only are many hospitals overwhelmed, but so are orphanages, social security schemes, and the education system. HIV/AIDS policies and programmes need to be developed and implemented to ensure access to employees of public services to HIV prevention, care and support.

In addition to the ILO Code of Practice on HIV/AIDS and its Education and Training Manual, the ILO has developed a number of policy guidelines and tools to support the ministries of Labour in their initiatives including:

• A handbook on HIV/AIDS for labour and factory inspectors.
• Guidelines on addressing HIV/AIDS in the workplace through employment and labour law.
• Joint ILO/WHO guidelines on health services and HIV/AIDS.
• Implementing the ILO code of practice on HIV/AIDS and the world of work. An education and training manual.
• An HIV/AIDS Workplace Policy for the Education Sector in the Caribbean.
• An HIV/AIDS Workplace Policy for the Education Sector in Southern Africa.